National Reporting Instrument 2018
Background
[iBG]
Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.
The deadline for submitting reports is 15 August 2018.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.
The deadline for submitting reports is 15 August 2018.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
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Please describe
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
Designated National Authority Contact Details
[q01a]
Name of Member State:
Bangladesh
[q01b]
Contact information:
Full name of institution:
Directorate General of Health Services, Government of the Peoples Republic of Bangladesh
Name of designated national authority:
Prof. Dr. Abul Kalam Azad, Director General, Directorate General of Health Services
Title of designated national authority:
Director General, Directorate General of Health Services
Telephone number:
+88-02-9899516; +88-02-88121424
Email:
profakazad@gmail.com; dghsbd@gmail.com
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[q2]
2. To describe the steps taken to implement the Code, please tick all items that may apply from the list below
2.a Actions have been taken to communicate and share information across sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies, nationally and/or sub-nationally.
Implementation of the Code has been made as an activity in the Bangladesh Health Workforce Strategy (2015-2021), which was widely disseminated among the key stakeholders in 2016. However, full implementation has not yet been taken place.
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
No such step yet taken.
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
Ministry of Overseas Employment and Expatriate Welfare maintains records of all registered recruiters of overseas employment.
2.d Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
Not yet done.
2.e Measures have been taken to consult stakeholders in decision-making processes and/or involve them in activities related to the international recruitment of health personnel.
An initiative was undertaken to formulate the action plan for implementation of the Code in 2015 through a consultative process. After that no significant step was undertaken.
2.f Other steps:
Need to take more steps on this.
[q3]
3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
3.b Support for policy dialogue and development
3.c Support for the development of bilateral agreements
3.d Other areas of support:
Data on International Health Personnel Recruitment & Migration
[iq4]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q4]
4. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[q4x1]
Please describe:
Partially yes. Bangladesh Medical and Dental Council (BMDC) keeps record on foreign-born and foreign-trained health personnel of the medical doctors. Bangladesh Nursing and Midwifery Council (BNMC) keeps record of the nurses.
[iQ5]
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
[q5x1]
5. Data on the stock of health personnel, disaggregated by country of training and birth
5.1 Consolidated stock of health personnel
5.1 Consolidated stock of health personnel
| Total | Domestically Trained | Foreign Trained | Unknown Place of Training | National Born | Foreign Born | Source* | Additional Comments# | |
|---|---|---|---|---|---|---|---|---|
| Medical Doctors | 85633 | n/a | ~300 | n/a | n/a | n/a | BMDC, December 2017 | n/a |
| Nurses | 48001 | n/a | n/a | n/a | n/a | n/a | BMDC, September, 2017 | Three years Diploma Nurse-midwife |
| Midwives | 1187 | n/a | n/a | n/a | n/a | n/a | BMDC, March, 2018 | Three years Diploma Midwife |
| Dentists | 8130 | n/a | n/a | n/a | n/a | n/a | BMDC, December, 2017 | n/a |
| Pharmacists | 12078 | n/a | n/a | n/a | n/a | n/a | Pharmacy Council of Bangladesh, March, 2018 | n/a |
[iq5x2]
5.2 Country of training for foreign-trained health personnel
Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
[q5x2x2]
Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
[Q5fn]
*e.g. professional register, census data, national survey, other
#e.g. active stock, cumulative stock, public employees only etc.
#e.g. active stock, cumulative stock, public employees only etc.
Partnerships, Technical Collaboration and Financial Support 1/2
[q6]
6. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
6.a Specific support for implementation of the Code
6.b Support for health system strengthening
6.c Support for health personnel development
6.d Other areas of support:
[q7]
7. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
7.a Specific support for implementation of the Code
7.b Support for health system strengthening
7.c Support for health personnel development
7.d Other areas of support:
Develeopment of the draft action plan for implementation of the Code was supported by WHO Bangladesh in 2015. The Code was introduced to the officials of the ministry, DGHS and others agencies.
Partnerships, Technical Collaboration and Financial Support 2/2
[q8]
8. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements to promote international cooperation and coordination in relation to the international recruitment and migration of health personnel?
Yes
[q8x1]
8.1 Please provide the text and/or web-links to the agreements or arrangements
Please upload file
[q8x1wl]
Web-links:
Several agreements/form of agreements are made or being made with the other governments or with organizations in other countries. Such as: angamata Sheikh Fazilatunnessa Mujib KPJ Specialized Hospital and Nursing College was established in 2016/2017 with technical support from the Malaysian Private Sector Healthcare Organization KPJ
[q8x2]
8.2 If documentation is unavailable, please use Table A on next screen to describe the bilateral, regional or multilateral agreements or arrangements:
Table A Description of bilateral, multilateral, regional agreements or arrangements
Table A Description of bilateral, multilateral, regional agreements or arrangements
1.
2.
3.
4.
5.
[q8x2fx1]
Title of Agreement
See description above
[q8x2ax1]
Type of Agreement
Bilateral
[q8x2bx1]
Countries Involved
Bangladesh
Malaysia
[q8x2cx1]
Coverage
National
[q8x2dx1]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex1]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx1]
Validity period
2016/2017
[q8x2fx2]
Title of Agreement
[q8x2ax2]
Type of Agreement
[q8x2bx2]
Countries Involved
[q8x2cx2]
Coverage
[q8x2dx2]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex2]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx2]
Validity period
[q8x2fx3]
Title of Agreement
[q8x2ax3]
Type of Agreement
[q8x2bx3]
Countries Involved
[q8x2cx3]
Coverage
[q8x2dx3]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex3]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx3]
Validity period
[q8x2fx4]
Title of Agreement
[q8x2ax4]
Type of Agreement
[q8x2bx4]
Countries Involved
[q8x2cx4]
Coverage
[q8x2dx4]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex4]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx4]
Validity period
[q8x2fx5]
Title of Agreement
[q8x2ax5]
Type of Agreement
[q8x2bx5]
Countries Involved
[q8x2cx5]
Coverage
[q8x2dx5]
Main content of agreements (Include all that apply)
Education and training
Institutional capacity building
Promotion of circular migration
Retention strategies
Recognition of health personnel
Recruitment of health personnel
Twinning of health care facilities
Other mechanism (include details if possible)
[q8x2ex5]
Categories of Health Personnel (Include all that apply)
Doctors
Nurses
Midwives
Dentists
Pharmacists
Other (include details as necessary)
[q8x2gx5]
Validity period
[q8x3]
8.3 Are recommendations of the WHO Global Code reflected in the agreements (e.g. taking into account the needs of developing countries)?
Yes/Partly
Health Workforce Development and Health System Sustainability
[q9]
9. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including through measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
[q9x1]
9.1 Measures taken to educate the health workforce
Until December 2017, about 750 health professional education institutions have been established under the Ministry of Health and Family throughout the country, which are involved in educating the health workforce covering medical doctors (MBBS), dentist (graduates), nurses (both graduates midwives (diploma), medical technologists (diploma), and medical assistants (diploma).
9.2 Measures taken to retain the health workforce
Steps are undertaken to improve retention of the health workforce in rural and hard to reach areas such
as minimum two years compulsory service of the medical doctors and allowances for service in hard to reach areas. However, few other options
are also in consideration such as introducing internship of the fresh medical graduates in rural and hard t o reach areas, pay for performance and
creating new positions.
9.3 Measures taken to ensure the sustainability* of the health workforce
An initiative of conducting health labour market analysis has been undertaken in 2018 at national level where demand and
supply analysis of the health workforce will be focused. Result of this analysis is expected to be available in 2019. This is an activity to be carried
as part of the Bangladesh Health Workforce Strategy 2015.
9.4 Measures taken to address the geographical mal-distribution of health workers
Constant transfer-postings of the health workforce is on-going, which address in many extend the mal-distribution issues
of the health workforce in the public sector. However, the upcoming health labour market analysis will provide more clear picture of this matter.
[q10]
10. Are there specific policies and/or laws, across governmental ministries, for internationally recruited and/or foreign-trained health personnel in your country?
Yes
[q10x1]
10.1 Please provide further information in the box below:
There is a specific policy for recruitment of the specialized foreign medical doctors and nurses, whch is recently updated
in 2018 in Bangladesh.
[q11]
11. Recognizing the role of other parts of government, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
No
[q12]
12. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
[q12x1]
12.1 Please provide further information in the box below:
Ministry of Overseas Employment and Expatriate Welfare leads on compilation and drafting laws and regulations of all type of workers including health workers.
[q9x3fn]
*Health workforce sustainability reflects a dynamic national health labour market where health workforce supply best meets current demands and health needs, and where future health needs are anticipated, adaptively met and viably resourced without threatening the performance of health systems in other countries (ref: Working for Health and Growth, Report of the High-Level Commission on Health Employment and Economic Growth, WHO, 2016, available from http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf?ua=1
).
Responsibilities, Rights and Recruitment Practices
[q13]
13. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
13.a Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
13.b Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
13.d Other mechanisms, please provide details below if possible:
[q14]
14. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
N/A
[q15]
15. Please submit any comments or information on policies and practices to support the integration of foreign-trained or immigrant health personnel, as well as difficulties encountered.
N/A
[q16]
16. Regarding domestically trained/ emigrant health personnel working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
N/A
Constraints, Solutions, and Complementary Comments
[q17]
17. Please list in priority order, the three main constraints to the implementation of the Code in your country and propose possible solutions:
| Main constraints | Possible solution | |
|---|---|---|
| Lack of effective communication among the policy makers | WHO should provide support on this. | |
| Lack of capacity - organizational as well as individial. | Benefits of the Code should be widely disseminated. | |
| n/a | n/a |
[q18]
18. Please submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
[q18x1]
Please upload any supporting files